Intramedullary nailing for displaced proximal humeral fractures

Abstract

Purpose: To evaluate outcomes of 28 patients who underwent intramedullary nailing for displaced proximal humeral fractures.

Methods: 24 women and 4 men aged 38 to 87 (mean, 65) years underwent intramedullary nailing for displaced proximal humeral fractures. 17 (61%) of them were aged >70 years. Fractures were classified into 2-part (n = 8), 3-part (n = 17), and 4-part (n = 3), and corresponded to AO 11 A3 (n = 8), B1 (n = 3), B2 (n = 9), and C2 (n = 8) types. The Constant and Oxford scores were assessed at the final follow-up.

Results: All patients had bone union except for one who had tuberosity failure. 23 (82%) patients had satisfactory-to-excellent and 5 had poor Constant scores; outcomes were worse with more complex fractures. 20 (71%) patients had satisfactory Oxford scores. Seven (25%) patients had impingement of a nail tip. Other complications included avascular necrosis (n = 1), proximal locking screw back-out (n = 1), and screw penetration into the joint (n = 1).

Conclusion: Intramedullary nailing provides a stable fixation with minimal soft tissue dissection for displaced proximal humeral fractures. It enables early mobilisation and functional recovery.